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Cholelithiasis in childhood: a cohort study in north of iran
Mohammad-Reza Esmaeili Dooki1, Alireza Norouzi2
1Pediatric Gastroenterologist, Non-Communicable Pediatric Diseases Research Center, Babol, Iran.
Insights
In children, ceftriaxone therapy and hemolytic diseases are common causes of gallstones (cholelithiasis). Most pediatric patients with gallstones do not require surgery, indicating conservative management is often effective.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Pediatric Surgery
Background:
- Gallstones (cholelithiasis) are uncommon in children but increasingly detected via ultrasonography.
- Epidemiology and predisposing factors for pediatric cholelithiasis vary globally.
- Understanding local factors is crucial for effective management of pediatric gallstones.
Purpose of the Study:
- To describe the clinical presentation of pediatric cholelithiasis.
- To identify predisposing factors for gallstones in children.
- To evaluate the management and outcomes of children with cholelithiasis.
Main Methods:
- A cohort study of children diagnosed with cholelithiasis between 2000 and 2011.
- Diagnosis confirmed by ultrasonography.
- Data collected via history, physical examination, and clinical/paraclinical investigations; analyzed using SPSS v.18.
Main Results:
- 66 children with cholelithiasis; 59.1% were male, mean age 6.6 years.
- Common predisposing factors: ceftriaxone therapy (27.3%), hemolytic diseases (13.6%).
- Abdominal pain was the most frequent symptom (67%); only 9% required cholecystectomy.
Conclusions:
- Ceftriaxone therapy and hemolytic diseases are key predisposing factors for pediatric cholelithiasis in this region.
- Most children with gallstones in this cohort did not require surgical intervention (cholecystectomy).
- Findings highlight the importance of identifying specific risk factors and the potential for non-surgical management in pediatric gallstone cases.
Objective:
Cholelithiasis rarely occurs in children but the increased use of ultrasonography has led to increased detection of gallstones in patients. The epidemiology and predisposing factors of cholelithiasis vary in different populations. The aim of this study was to describe the clinical presentation, predisposing factors and to evaluate management and outcome of patients referred to Amirkola Children's Hospital jn Babol.
Methods:
This cohort study was performed on children with cholelithiasis referred during 2000 to 2011. Cholelithiasis was diagnosed with ultrasonography. The data was obtained based on history, physical exam, clinical and paraclinical investigations and analyzed by SPSS version 18. P-value <0.05 was considered being significant.
Findings:
From the 66 patients with cholelithiasis, 39 (59.1%) were males. The mean age at diagnosis was 6.6±4.5 years. The most common predisposing factor included ceftriaxone therapy (27.3%), hemolytic diseases (13.6%), hepatobiliary diseases (7.5%) and cystic fibrosis (7.5%). In 30.3% of patients, no predisposing factor was detected. The most common complaint was abdominal pain (67%). Among the patients in whom abdominal X-Ray was performed, only 20% had radiopaque gallstones; 6 (9%) patients underwent cholecystectomy.
Conclusion:
According to this study, ceftriaxone therapy and hemolytic diseases were the most common predisposing factors in children with cholelithiasis in our area and cholecystectomy had not been needed in most patients.
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